tbuckley/cabot-search huggingface dataset:
PB1842: EARLY DEATH IN NEWLY DIAGNOSED ADULT ACUTE MYELOID LEUKEMIA
Authors: N. Siala, Y. Fakhfekh, I. Ben Amor, F. Kallel, I. Frikha, O. Kassar, M. Chaari, N. Louati, H. Sennana, L. Khelifa, M. Charfi, S. Hadiji, M. Medhaffar, M. Elloumi
Journal: HemaSphere (2022)

Background: Recent advances have led to higher response rates and improved survival in patients with newly diagnosed acute myeloid leukemia (AML). However, early death, remain important challenges. Aims: The aim was to explore risk factors for early mortality in adult AML patients in Southern Tunisia. Methods: Our study is retrospective over 15 years (2005-2019). Patients included (age: 20- 60 years old) were diagnosed with de novo AML, diagnosed in the clinical hematology department of Hedi Chaker Sfax Hospital / TUNISIA. Secondary leukemia and FAB m3 were excluded. We assessed the one-month mortality in these patients. Results: One hundred seventy-seven patients with newly AML were in indication of treatment with intensive CT. Thirty-seven died early (21%). The factors that significantly influence the rate of ED are age, gender, delay in diagnosis and the presence of disseminated intravascular coagulation (DIC) (Image/Table). Death before the start of CT was found in 6 cases (16%) with a median time between diagnosis and death of 5 days [2-28]. Respiratory distress was the only cause of death before treatment, which was caused by intra-alveolar hemorrhage, pulmonary leukocytosis and hypoxemic infectious pneumonitis in 3, 2 and 1 case respectively.Thirty-one patients (84%) died during the induction cure with a median time between the start of the cure and death of 17 days [2-29]. The causes of death during the induction cure were multiple. Death by respiratory distress in 15 cases (48%) originating from: intra-alveolar hemorrhage, PAO and hypoxemic infectious pneumonitis in 7, 4 and 4 cases respectively. Severe sepsis was the cause of death in 11 cases (35%). In the remaining 5 cases the cause of death was: compressive pericardial effusion (2 cases), cerebral hemorrhage (1 case), hyperosmolar coma (1 case) and status epilepticus (1 case). Image:Summary/Conclusion: The ED rate in our series is higher than those described in the literature (21% vs 5-10%). Advanced age, gender, delay in diagnosis and initial DIC were the risk factors for ED in our study. Death most commonly occurs from infectious or bleeding complications related to cytopenia. Early diagnosis of AML and improve supportive care is essential to reduce the ED rate and improve overall survival by establishing early treatment
PB1985: CHEMO OR CHEMO-FREE REGIMENS IN HEAVILY PRETREATED MULTIPLE MYELOMA? ROLE OF BENDAMUSTINE-BORTEZOMIB-DEXAMETHASONE (BVD) IN NOVEL AGENTS’ ERA
Authors: C. Cerchione, D. Nappi, A. E. Pareto, S. Ronconi, D. Cangini, M. Ceccolini, G. Musuraca, L. Catalano, G. Martinelli
Journal: HemaSphere (2022)

Background: The treatment of heavily pretreated Multiple Myeloma continues to be considered as an important unmet clinical need. Bendamustine is an old bi-functional alkylating agent which has proved to be effective in relapsed, refractory and in new diagnosed Multiple Myeloma (MM). Aims: Thus, aiming to provide further insights in this field, also in novelagents’era, we present here a retrospective, real-life analysis of patients with relapsed/refractory MM (rrMM), who had received salvage therapy with bendamustine in combination with bortezomib and dexamethasone (BVD). Methods: 81 patients (44 M/37 F), with rrMM, median age at diagnosis 59.4 years (r. 36-82), median age at start of treatment 63.6 years (r.37-86) treated with several lines of treatments (median 6, r. 2-11), every refractory to all the drugs previously received (also Bortezomib), received BVD (B 90 mg/sqm days 1,2; V 1.3 mg/sqm days 1,4,8,11, D 20 mg days 1,2,4,5,8,9,11,12, Pegfilgrastim day +4) every 28 days, until progression. All patients had previously received bortezomib-based and IMIDs-based treatments, and 32% (26/81) had also received radiotherapy. 69% (56/81) had undergone single or double autologous and three (2%) allogeneic stem cell transplant. All patients were relapsed and refractory to last therapies received before BVD. Results: Bendamustine was well tolerated, with grade 3-4 transfusion-dependent anemia in 56% (46/81) of patients, and 43% (35/81) grade 3-4. Bendamustine was well tolerated, with grade 3-4 transfusion-dependent anemia in 56% (46/81) of patients, and 43% (35/81) grade 3-4 neutropenia (no ospedalization was required, no septic shocks wereobserved). No severe extrahematologic toxicity was observed, only grade 1 gastrointestinal side effect (nausea), treated by common antiemetic drugs. According to IMWG, ORR was 63% (51/81: 7 CR, 18 VGPR, 15 PR, 11 MR) with11 PD and 19 patients in SD, which can be considered as an impressive resultin this subset of rrMM patients. In particular, for 11 patients, BVD was, after having achieved at least a PR, a bridge to second auSCT, and for two patients a bridge to alloSCT. Eight patients have surprisingly achieved a notable PRafter failure of novel agents (i.e. Carfilzomib, Daratumumab and Pomalidomide). Median time to response was 1.3 months (r.1-3), median OS from diagnosis was 67.3 months (r.6-151), median OS from start of Bendamustine was 9.6 months (r.2-36). Summary/Conclusion: The triplet Bendamustine-Bortezomib-Dexamethasone has shown significant efficacy in a particularly severe setting of patients, relapsed and refractory to all available therapeutic resources, and, in particular cases, it could be considered as a bridge to a second autologous or allogenic SCT,also after failure of novel agents.
P1599: THERAPY AND HOSPITAL MORTALITY PREDICTORS IN PATIENTS WITH LYMPHOPROLIFERATIVE DISORDERS AND CONCOMITANT COVID-19 INFECTION
Authors: Y. Polyakov, K. Kaluzhskaya, E. Baryakh, E. Gemdzhian, E. Misyurina, E. Zhelnova, K. Yatskov, O. Kochneva, S. Andreev, T. Chudnova, D. Ivanova, T. Tolstykh
Journal: HemaSphere (2022)

Background: COVID-19 infection increases the risk of hospital mortality in patients with lymphoproliferative disorders (LPD). Aims: The aim of the study was to identify the predictors of hospital mortality in adult patients with LPD and concomitant COVID-19. Methods: 335 patients (53% of whom were male) aged 18 to 92 years (median age = 57) with LPD and COVID-19 were followed up by the hematology service of Moscow City Clinical Hospital No.52 (Moscow) from April 21, 2020 to December 31, 2021. The overall survival curve was constructed and multivariate analysis using a Cox regression model was performed to determine the predictors of hospital mortality. Results: This retrospective study included patients with the following disorders: diffuse large B-cell lymphoma, follicular lymphoma, primary mediastinal B-cell lymphoma, mantle cell lymphoma, marginal zone lymphoma, hairy cell leukemia, Hodgkin’s lymphoma, Burkitt lymphoma, and T-cell lymphoma. The Charlson Comorbidity Index score was 5 points, and median time from the first symptoms to hospital admission was 7 days. The disease status included remission (n=143; 43%), relapse/progression (n=76; 23%), stable disease (n=96; 29%), newly diagnosed hematologic malignancy (n=16; 5%). The majority of patients had moderate to severe lung tissue involvement. Grade 4 neutropenia was reported in 150 patients who had a high level of C-reactive protein (median=115 mg/L), a significantly elevated D-dimer (median = 912 ng/mL) and fibrinogen (median=6.5 g/L) levels. Mean ICU length of stay was 9 days, and 21% of patients required mechanical ventilation. 182 patients were receiving combination chemotherapy for LPD within a month prior to the onset of COVID-19. 209 patients were treated with anti-CD20 monoclonal antibodies within a year prior to the onset of COVID-19. Hospital therapy included IL-6 receptor antagonists, antimicrobial therapy (aminopenicillin/beta-lactamase inhibitor + fluoroquinolone as the first line therapy and ureidopenicillin or a fourth-generation cephalosporin/beta-lactamase inhibitor + aminoglycoside as the second line therapy), and antifungal therapy (38% of patients). Hospital mortality rate was 21% (70/335) (Fig. 1). According to the results of the multivariate (cox regression) analysis, significant predictors of hospital mortality included the age (>65 years), 2.0 (1.1-5.2), р=0.05; hematologic malignancy status (relapse or progression/remission), 2.4 (1.3-4.3), р=0.008; CT severity score (4/0), HR=2.9 (95% CI: 1.2-7.1), р=0.004 and grade 4 neutropenia (yes/no), 1.5 (0.9-2.7), р=0.09 (Fig. 2). Image:Summary/Conclusion: Mortality rate in patients with LPD was 21%. The following significant predictors of hospital mortality have been identified: age >65 years, relapse/disease progression, CT severity score index of 4, grade 4 neutropenia.
PB1924: ARE WE TAKING ADVANTAGE OF THERAPEUTIC OPTIONS IN MYELODYSPLASTIC SYNDROME?-REAL WORLD DATA FROM HUNGARY
Authors: Z. Miltényi, A. E. Dr Gál, D. Tóthfalusi, Á. Prof Dr Illés
Journal: HemaSphere (2022)

Background: The majority of patients with myelodysplasia (MDS) are over 70 years of age, so the only curative treatment, allogeneic stem cell transplantation, can be given to only a few patients. However, treatments available in recent years (lenalidomide, azacitidine, erythropoietin) may improve both quality of life and survival, so it is important to identify and treat these patients where possible. Aims: Analysis of the characteristics, treatment modalities, and survival outcomes of our MDS patients. Methods: Data from MDS patients diagnosed and treated at our department were analyzed retrospectively between January 1, 2010 and December 31, 2020. We compared the characteristics of patients treated before and after 2015 and their treatment. Allogeneic transplantation, azacitidine, lenalidomide and erythropoietin treatment were considered active treatments. Transfusions, GCSF, and chelating agents were considered supportive treatments. Results: A total of 341 patients had confirmed MDS during this period, with a mean age of 69.52 (23-95) years and a median survival of 31.77 (0-385) months. 56% of patients were older than 70 years at diagnosis and only 8% were younger than 50 years. The most common histological subtype (44.57% of patients) wasrefractory cytopenia with multilineage dysplasia. Based on IPSS, 78% of patients were in the low and intermediate 1 risk groups. 78% of patients already required transfusion at diagnosis and 55% of all patients received supportive care only. While 39% of patients diagnosed before 2015 received active treatment alone, 51% of patients in the group diagnosed after 2015 already received active treatment (p=0.061). 40% of patients died and an additional 35% were lost from follow-up. Overall survival of patients in the low and intermedier-1 group was significantly better than the intermedier-2 and high risk group (p=0.000). Until 2015 the survival of actively treated patients was worse, in the period after 2015 an improving trend can already be observed, which is more due to the low and intermedier-1 risk patients thanks to the available active treatment. Image:Summary/Conclusion: Although the only curative treatment remains the allogeneic transplantation in MDS, therapies have become available with therapies available since 2015. For this reason, we must strive for the earliest and most accurate diagnosis possible.
Abstract 689: A randomized phase III study assessing the efficacy of liquid biopsy in early diagnosis of recurrence and second malignancies in lung cancer survivors
Authors: Sana Raoof
Journal: Cancer Research (2022)

Abstract We designed a 6,000-patient prospective, multi-institutional randomized clinical trial to assess the efficacy of liquid biopsy in early diagnosis of recurrence and second malignancies in lung cancer survivors. To ensure over 25% of participants are of disadvantaged or minority status, we have recruited multiple community hospitals (Jamaica, Flushing, Wyckoff, and Staten Island/Bronx satellites of Northwell hospitals) to the study in partnership with Memorial Sloan Kettering Cancer Center. Patients included in this study are survivors of non-metastatic non-small cell lung cancer, status-post definitive treatment (surgery or radiation) with no evidence of disease for at least one year. These patients may be on maintenance therapy for their prior lung cancer but may not have any other active malignancy at the time of enrollment. Participants will be randomized 1:1 to standard surveillance at the discretion of the treating physician or standard surveillance plus six-monthly methylation-based liquid biopsy tests over a two-year study period, and strict guidelines on follow-up of positive liquid biopsy testing will be provided to reduce harms from false positives or overdiagnosis. The primary endpoint of this study is the incidence of late stage cancer (distant recurrence or new primary cancer of stage III/IV). Secondary endpoints include incidence of early cancers (locoregional recurrence or new primary cancer of stage I/II), metastasis-free survival, and utilization of liquid biopsy versus standard of care scans. We will stratify our results by minority and socioeconomic status to specifically ascertain the effect of this intervention on populations of need. This is the first randomized controlled trial of liquid biopsy in a survivor population and the first trial utilizing liquid biopsy in a large minority population. We will have preliminary experiences to report in April 2022. Citation Format: Sana Raoof. A randomized phase III study assessing the efficacy of liquid biopsy in early diagnosis of recurrence and second malignancies in lung cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 689.
P1621: ANAPHYLACTIC SHOCK TO A HEMATOLOGICAL DISORDER PATIENT DURING TRANSFUSION OF A PLATELET APHERESIS UNIT STORED IN PLATELET ADDITIVE SOLUTION: A RARE CASE REPORT
Authors: B. Bhasker
Journal: HemaSphere (2022)

Background: Adverse transfusion reactions from transfusion of apheresis platelets (AP) stored in Platelet additive solution (PAS) are uncommon, as PAS is a balanced electrolyte solution developed to replace plasma from platelet concentrates as the storage medium. No anaphylactic reactions have ever been reported due to transfusion of AP stored in PAS. Aims: The main objective of the study is to understand the reaction occurred due to apheresis platelet transfusion. Methods: An AP product was donated by a blood group A male, processed using PAS. The patient developed severe Hypotension with Tachycardia immediately after 10 minutes of transfusion. Pre-transfusion and Post transfusion recipient vitals showed a marked decrease in Blood Pressure from 110/70 mmHg to 70/50 mm Hg with Pulse increased from 88 bpm to 118 bpm. Oxygen saturations were maintained normal without any changes in respiratory parameters. Serological testing included an antibody screen using gel technology, a direct antiglobulin test (DAT) using immunoglobulin G and C3d, and a Sterility testing of the transfused platelet product. Results: A 61-year-old blood group O patient with Aplastic anemia developed severe hypotension within the first 10 minutes of the start of AP in PAS transfusion despite premedication with Inj. Avil and Inj.Hydrocort. The post-transfusion reaction evaluation was non-significant showing negative antibody screen and also negative DAT, both for immunoglobulin G and C3d; No bacterial growth was seen in the transfused product and patient blood culture was sterile. Ruling out hemolytic and septic transfusion reactions. The patient was resuscitated with Inj. Adrenaline and got shifted to ICU for further follow-up. The patient vitals got stabilized after 4 hours and got discharged in hemodynamically stable condition. Notably, a group O patient at a different hospital received a split of the same apheresis unit, with no reaction. Summary/Conclusion: To our knowledge, this is the first case with anaphylactic shock reported from Apheresis platelet transfusion stored in PAS. The fact that one transfusion recipient had anaphylactic shock whereas another did not have any reported reaction highlights the potential importance of recipient variables in adverse transfusion reactions.
Abstract LB110: Twist pan-cancer synthetic reference materials for cell-free DNA (cfDNA) assay development
Authors: Patrick D. Cherry
Journal: Cancer Research (2022)

Abstract Liquid biopsies hold great promise in reducing the burden of the disease of cancer on patients. Early detection of cancer via the cell free DNA represents the broadest vision and requires highly specificity. Ongoing disease monitoring is another important application of liquid biopsy and requires high sensitivity. Assay development requires analytical validation, and assays must be monitored for ongoing performance. These assays demand reference materials at specific variant allele frequencies for the assessment of specificity and sensitivity. Previously, obtaining reference materials was a laborious process of finding or engineering mutant cell lines. Here, we describe the design, manufacture, and quality control of a synthetic reference standard: the Twist Pan-Cancer Reference Standards, developed using Twist’s proprietary DNA printing platform to include a wide selection of both common and rare cancer targets for analytical validation. The reference material closely mimics the size distribution and content of cell-free DNA, with a primary peak at 167 bp and a secondary peak at 334 bp. The background cfDNA is derived from a single donor and highly characterized through NGS. The reference standard includes over 400 variant sites across 84 genes, including literature-curated, clinically-relevant variant sites. Additional panel-wide variants were included to aid in troubleshooting capture panels. The variant DNA is synthetically printed at 167 bp ± 5 bp and tiles over the site with extensive overlap, providing diversity of DNA termini relative to the position of the site of variation. Variant sites were printed and quantified independently so they can be pooled uniformly. NGS quality controls are implemented at multiple steps to ensure quality. The final products are available in a variant allele frequency (VAF) dilution series. The dilution series is quality controlled using droplet digital PCR (ddPCR) to ensure precision of variant allele frequencies. The Twist Pan Cancer Reference Standards provide a valuable solution for NGS-based assay developers seeking reference materials for a wide array of cancer variants, advancing adoption of liquid biopsy tests toward routine clinical practice. Citation Format: Patrick D. Cherry. Twist pan-cancer synthetic reference materials for cell-free DNA (cfDNA) assay development [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB110.
PB2297: THE PREDICTIVE VALUE OF PLATELET SPECIFIC ANTIBODIES FOR THE FIRST-LINE TREATMENT EFFECT IN NEWLY DIAGNOSED PEDIATRIC ITP
Authors: S. Dong
Journal: HemaSphere (2022)

Background: Immune thrombocytopenia (ITP) is an autoimmune mediated hemorrhagic disease characterized by thrombocytopenia. Platelet specific antibodies play a key role in platelet destruction. Aims: This study was aimed to determine whether platelet specific antibodies (including anti-GPIIb/IIIa, anti-GPIb/IX and anti-GPIa/IIa antibodies) are related to the first-line treatment effect of newly diagnosed pediatric ITP. Methods: This study retrospectively analyzed 154 newly diagnosed ITP patients from October 2016 to September 2021 in Beijing Children’s Hospital. These patients were treated with glucocorticoids and/or intravenous immunoglobulin (IVIG). And platelet counts were detected one week and one month after treatment. Platelet specific antibodies were detected by PAKAUTO. Results: When the antibody levels were divided into positive and negative, children with positive anti-GPIb/IX antibody responded worse than those with negative anti-GPIb/IX antibody at both one week and one month (Z=-2.565, P=0.010; Z=-2.579, P=0.010). When the antibody titer ratio was used to reflect the antibody levels, there was no significant difference between platelet specific antibodies and the first-line treatment effect in newly diagnosed pediatric ITP. Summary/Conclusion: Anti-GPIb/IX antibody is a sign of worse response in newly diagnosed pediatric ITP.
Who’s Abandoning Whom? The Role of Ethics Consultation for Unaccompanied Emergency Department Patients with Dementia
Authors: Anita J. Tarzian
Journal: The American Journal of Bioethics (2022)

"Who’s Abandoning Whom? The Role of Ethics Consultation for Unaccompanied Emergency Department Patients with Dementia." The American Journal of Bioethics, 22(7), pp. 84–85
PB1931: HEMATOLOGICAL COMPLICATIONS OF COVID IMMUNIZATION-CASE SERIES
Authors: A. Aribandi, C. Ranjith Kumar, K. Ashok Kumar
Journal: HemaSphere (2022)

Background: Effective vaccines are most powerful armamentariums in our fight against global COVID-19 pandemic. Based on available literature, the benefits of vaccination significantly outweigh the low risk of blood clots and other hematological complications reported following vaccination. Here we are reporting 6 such rare complications of COVID immunization which was happened within 4days -42days following vaccination. Aims: we aimed to study the rare hematological adverse events follwoing the COVID vaccination Methods: Here we are reporting six cases presented to our institute following COVID vaccination within 4 weeks following vaccination, data were retrieved from MRD and events and outcomes were tabulated. Results: - S.No AgeYrs. Sex Vaccine type COVID infection Presentation Time between Vaccination and effect Treatment Outcome 1 62 M Covishield No Severe aplastic anemia(SAA) 17days ATG+CSA+Elthrombopag EBV HLHAlive 2 44 F Covishield No SAA 24days ATG+CSA+Elthrombopag Portal vein thrombosisAlive 3 62 F Covishield No SAA 42days ATG+CSA+Elthrombopag Died,Fungal pneumonia 4 64 F Covishield No ITP(Immune mediated thrombocytopenia) 18days Steroids Complete response,Alive 5 82 F Covishield No ITP 26days Steroids Complete response,Alive 6 69 F Covishield No ITP 28days IVIg, SteroidsRomiplastim Complete response,Alive Summary/Conclusion: Hematological complications commonly reported following COVID-19 vaccination were thrombosis with thrombocytopenia syndrome following AstraZeneca vaccination. However for severe aplastic anemia literature was scanty and hardly any reports in the literature search.In our paper we reported three severe aplastic anemia and 3 Immune thrombocytopenic Purpura following Astrazenca vaccination. Need high index of suspicion and Bone marrow examination required to confirm the underlying entity appropriately.